Provider Demographics
NPI:1356572697
Name:SHAPIRO, LYUBOV (NP)
Entity type:Individual
Prefix:
First Name:LYUBOV
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S NAPERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5423
Mailing Address - Country:US
Mailing Address - Phone:630-221-0200
Mailing Address - Fax:708-491-2481
Practice Address - Street 1:3115 N WILKE RD
Practice Address - Street 2:STE A & B
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1451
Practice Address - Country:US
Practice Address - Phone:224-795-5700
Practice Address - Fax:224-795-5705
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007678363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner